竹叶(二把) 石膏(一斤) 半夏(半升洗) 麦门冬(一升去心) 人参(三两) 甘草(二两炙) 粳米(半
升)
上七味。以水一斗。煮取六升。去滓。内粳米。煮米熟。汤成。去米。温服一升。日三服。
成注云。辛甘发散而除热。竹叶石膏甘草之甘辛。以发散余热。甘缓脾而益气。麦门冬人参粳米之甘。以补不足。
辛者散也。气逆者欲其散。半夏之辛以散气逆。
琥按上方。乃和解肺胃虚热。兼消停饮之剂。成注云辛甘发散。误矣。至若胃无大热。石膏在所当去胃无停饮。半
夏又非所宜。临证制方。不宜执也。
病患脉已解。而日暮微烦。以病新瘥人。强与谷。脾胃气尚弱。不能消谷。故令微烦损谷。则愈。(病患脉已解者。
谓脉不浮。又不沉实。表里之邪为尽除也。烦热也。日暮犹微热者。成注云。日暮为阳明王时。以病热新瘥之人。强与
谷食。食谷既多。脾胃气尚虚弱。一时不能消化。故令生烦热也。然其热甚微。止须减损其谷而病自愈。愚按此条。乃
不须服药证。故仲景止设一损谷之法。成注云。当小下之。是与前条食复证无别矣。误极误极。)
孙真人云。病新瘥后。但得食糜粥。宁少食。令饥。慎勿饱。不得他有所食。虽思之。勿与之也。引日转久。可渐
食羊肉白糜。若羹汁。雉兔鹿肉。不可食猪狗肉也。
琥按上孙氏云。宜食羊雉兔鹿等肉。夫雉属火而性温有毒。又羊鹿虽补。其性大热。恐病后不宜食也。倘少食羹
汁。亦无害。惟兔属金而性凉。为可食耳。
新瘥后。当静卧。慎勿早起。梳洗。亦不可多言语。用心使意劳烦凡此皆令人劳复。故督邮顾子献得病已瘥未健诣
华敷视脉。敷曰。虽瘥尚虚。未得复。阳气不足。慎勿劳事。余劳尚可。女劳(外台作御内)则死当吐舌数寸其妇闻其
夫瘥。从百余里来省之。经宿交接中间三日。发热口噤。舌出数寸而死。(按此段巢氏病源云出之范汪方中也。)病新瘥。
未满百日。气力未平复。而以房室者。略无不死。有士盖正者。疾愈后。六十日。已能行射猎。以房室。即吐涎而死。
及热病房室。名为阴阳易之病皆难治。多死。近者。有一士大夫小得伤寒。瘥已十余日。能乘马行来。自谓平复。以房
室。即小腹急痛。手足拘挛而死。
琥按上孙氏云云。皆女劳复也。外台秘要中引作阴阳易病。以致俗医妄谈云。阴阳易之病。有舌出数寸而死者。
殊不知阴阳易病。犹属可生。女劳复病大率多死。故千金但有治劳复之方。而无女劳复之药也。慎疾君子。其自谨之。
竹叶(二把) 石膏(一斤) 半夏(半升,洗净) 麦门冬(一升,去心) 人参(三两) 甘草(二两,炙烤) 粳米(半升)
以上七味药。用水一斗。煮取六升。滤去药渣。加入粳米。煮至米熟。汤剂制成。滤去米粒。每次温服一升。每日服用三次。
成无己注解说:辛甘发散以除热。竹叶、石膏、甘草的甘辛之性,用来发散余热。甘缓脾而益气。麦门冬、人参、粳米的甘味,用来补益不足。辛能散气。气逆者希望其散。半夏的辛味用来散气逆。
琥按:上述方子,是和解肺胃虚热,兼消停饮的方剂。成无己说是辛甘发散,这是错误的。至于胃中没有大热,石膏就应当去掉;胃中没有停饮,半夏又不适宜使用。临证制方,不应拘执不变。
病患脉象已解,但到了傍晚微微心烦。因为病刚痊愈的人,勉强进食,脾胃之气尚弱,不能消化食物,所以导致轻微烦热。减少饮食量,病就会好。(所谓“病患脉已解”,是指脉不浮,也不沉实,表里之邪已全部清除。烦热也。傍晚仍有微热,成无己注解说:傍晚是阳明经旺盛的时候。因为病热刚痊愈的人,勉强进食谷食。吃谷食过多,脾胃之气尚虚弱,一时不能消化,所以产生烦热。然而热势很轻,只需减少谷物摄入,病就能自愈。愚认为这一条,是不需要服药的证候,所以仲景只设立一个减少饮食的方法。成无己说:应当用小下法。这与前一条食复证没有区别了。错误至极,错误至极。)
孙思邈说:病刚痊愈后,只能吃糜粥。宁可少吃,让病人感到饥饿。千万不要吃饱。不得吃其他食物。即使想吃,也不要给他。过几天逐渐久一点,可以渐渐吃羊肉白糜。如果喝羹汁,可以吃雉鸡、兔子、鹿肉。不可以吃猪肉、狗肉。
琥按:上面孙氏说,适宜吃羊、雉、兔、鹿等肉。其中雉属火且性温有毒,另外羊、鹿虽然补益,但其性大热,恐怕病后不宜食用。如果少量喝羹汁,也没有害处。只有兔属金且性凉,是可以吃的。
病刚痊愈后,应当静卧。千万不要早起。梳洗,也不可多说话。用心使意劳烦。凡是这些都会导致劳复。所以督邮顾子献得病已经痊愈但未完全康复,去拜访华敷诊脉。华敷说:虽然痊愈但仍虚弱,未能恢复。阳气不足。千万不要从事劳累之事。其余的劳累还可以忍受,女劳(《外台秘要》作御内,指房事)则会死,会出现舌头吐出数寸的情况。他的妻子听说丈夫病愈,从百余里前来探望他。经过一夜交接,中间三天,发热口噤,舌头伸出数寸而死。(按:这段内容出自巢元方《诸病源候论》,引自范汪方中。)病刚痊愈,未满百日,气力未平复,而行房事的人,几乎没有不死。有个叫士盖正的人,病愈后六十天,已经能行走射猎,行房事后,即吐涎而死。以及热病期间行房事,名为阴阳易之病,都难治,大多死亡。近来,有一位士大夫小患伤寒,痊愈已十余日,能骑马行走,自认为平复,行房事后,即小腹急痛,手足拘挛而死。
琥按:上面孙氏所说的,都是女劳复。《外台秘要》中引用作为阴阳易病,以致俗医妄谈说:阴阳易病,有舌头吐出数寸而死的。殊不知阴阳易病,还是属于可生的情况,女劳复病大多死亡。所以《千金方》只有治疗劳复的方子,而没有治疗女劳复的药。谨慎对待疾病的君子,自己要谨慎啊。
Zhu Ye (Two handfuls) Shigao (One jin) Banxia (Half sheng, washed) Maimendong (One sheng, heart removed) Renshen (Three liang) Gancao (Two liang, roasted) Jingmi (Half sheng)
The above seven ingredients. Use one dou of water. Boil to obtain six sheng. Remove the dregs. Add Jingmi. Cook until the rice is ripe. The decoction is ready. Remove the rice. Take one sheng warm each time. Three times a day.
Cheng Wuji's annotation states: Acrid and sweet disperse and eliminate heat. The acrid and sweet nature of Zhu Ye, Shigao, and Gancao disperses residual heat. Sweetness soothes the Spleen and benefits Qi. The sweetness of Maimendong, Renshen, and Jingmi supplements insufficiency. Acridity disperses. For rebellious Qi, dispersion is desired. The acridity of Banxia disperses rebellious Qi.
Hu notes: The above formula is a harmonizing agent for deficiency-heat in the Lung and Stomach, combined with eliminating retained fluid. Cheng Wuji's claim of "acrid and sweet dispersion" is incorrect. If there is no significant heat in the Stomach, Shigao should be removed; if there is no retained fluid in the Stomach, Banxia is not suitable. In clinical prescription formulation, one should not adhere rigidly.
The patient's pulse has resolved, yet there is slight restlessness at dusk. This occurs because a person whose illness has just convalesced forces themselves to eat, while the Qi of the Spleen and Stomach remains weak and unable to digest food, thus causing slight restlessness. Reducing food intake leads to recovery. ("Patient's pulse has resolved" means the pulse is neither floating nor deep and solid, indicating that pathogenic factors in the exterior and interior have been completely eliminated. Restlessness and heat. The persistence of slight heat at dusk: Cheng Wuji annotates that dusk is the time when the Yangming channel is prosperous. Because a person recovering from heat illness forces themselves to consume grain food, excessive consumption of grain, coupled with still-weak Spleen and Stomach Qi that cannot digest it momentarily, generates restlessness and heat. However, the heat is very mild; merely reducing grain intake allows the disease to heal spontaneously. I believe this clause describes a condition requiring no medication, hence Zhongjing only establishes the method of reducing food intake. Cheng Wuji suggests using a mild purgative method, which is indistinguishable from the previous clause on dietary relapse. Extremely erroneous, extremely erroneous.)
Sun Simiao says: After the illness has just convalesced, one should only consume congee. It is better to eat less and feel hungry. Do not get full. Do not consume other foods. Even if craving them, do not provide them. After several days, gradually introduce mutton white congee. If consuming soup, pheasant, rabbit, or deer meat may be eaten. Pork and dog meat must not be consumed.
Hu notes: Regarding Sun's statement about eating mutton, pheasant, rabbit, and deer meat: Pheasant belongs to Fire and has a warm nature with toxicity. Although mutton and deer are tonifying, their nature is greatly hot, making them unsuitable post-illness. Consuming small amounts of soup poses no harm. Only rabbit, belonging to Metal and having a cool nature, is edible.
After convalescence, one should lie quietly. Do not rise early. Comb washing, nor speaking much. Mental exertion and worry all cause labor relapse. Thus, Gu Zixian, a Duzhou official, who had recovered from illness but was not fully robust, sought Hu Fu's pulse diagnosis. Hu Fu said: "Although recovered, still deficient, not yet restored. Yang Qi is insufficient. Avoid labor. Other labors may be tolerated, but sexual intercourse (Nü Lao, as recorded in Waitai Miyao) leads to death, manifesting as the tongue protruding several inches." His wife, hearing of his recovery, traveled over a hundred li to visit him. After one night of intercourse, within three days, he developed fever, trismus, and his tongue protruded several inches before he died. (Note: This passage originates from Chao Yuanfang's *Zhubing Yuanhou Lun*, citing Fan Wang's prescription.) For those whose illness has just convalesced, within one hundred days, while Qi and strength have not yet recovered, engaging in sexual intercourse results in almost certain death. A scholar named Shi Gaizheng, sixty days after recovery, could walk and hunt; upon engaging in sexual intercourse, he vomited saliva and died. Engaging in sexual intercourse during febrile illness is named Yin-Yang Yi disease, which is difficult to treat and often fatal. Recently, a scholar suffered minor Shanghan, recovered for over ten days, could ride a horse, believing himself restored, engaged in sexual intercourse, resulting in acute lower abdominal pain, spasm of hands and feet, and death.
Hu notes: What Sun Simiao described above are all cases of Nü Lao Fu (sexual activity-induced relapse). *Waitai Miyao* cites this as Yin-Yang Yi disease, leading vulgar physicians to falsely claim that Yin-Yang Yi disease causes death by tongue protrusion. They fail to realize that Yin-Yang Yi disease is potentially survivable, whereas Nü Lao Fu usually proves fatal. Hence, *Qianjin Fang* contains formulas for treating Lao Fu but no specific medicine for Nü Lao Fu. Gentlemen who respect health must exercise caution.